Last updated Feb. 8, 2023, by Marisa Wexler, MS
Fact-checked by Joana Carvalho, PhD
Damage to the body’s organs from lupus, an autoimmune disorder caused by a patient’s own immune system attacking healthy tissues, can result in a wide range of symptoms, from skin issues to kidney and bladder inflammation to problems with joints, muscles and bones, among others.
What are the common symptoms of lupus?
Lupus can affect almost any part of the body, and symptoms of the disease generally depend on which part(s) may be affected. Lupus symptoms and manifestations vary widely from person to person, and they also can change over time.
Skin issues like rashes and sores are common in lupus, affecting most people with the disease. Skin problems that only occur in lupus patients are the hallmark of cutaneous lupus, or types of lupus that affect the skin.
There are three main types of cutaneous lupus, each associated with a specific set of symptoms.
- Chronic cutaneous lupus or discoid lupus is characterized by round sores that mainly affect the face and scalp.
- Subacute cutaneous lupus is marked by the presence of a red scaly rash or red ring-shaped sores that commonly are found along the neck and arms.
- Acute cutaneous lupus causes a characteristic butterfly-shaped rash to appear on the cheeks and nose, which looks like a sunburn. This specific type of cutaneous lupus also may affect other body parts, such as the arms and legs.
Other skin-related problems that are common in lupus include:
- hair loss (alopecia), in which patchy or bald spots are common
- unusual sensitivity to sunlight (photosensitivity) that can trigger rashes and other symptoms
- sores (ulcers), which can appear in the mouth, nose, or vagina of female patients
- calcinosis, or hard, white lumps caused by a buildup of calcium underneath the skin.
Kidney and bladder problems
Inflammation in the kidneys, referred to as lupus nephritis, is one of the most severe complications of lupus. It causes damage to the kidneys and interferes with their ability to filter waste out of the body.
Common symptoms of lupus nephritis include:
- frequent urination, especially at night
- foamy urine, due to high levels of proteins in the urine
- swelling, most often in the lower limbs
- high blood pressure, known as hypertension.
Lupus also can cause inflammation in the bladder, referred to as lupus cystitis. Frequent urination is the most common symptom of this manifestation of lupus.
Joint, muscle, and bone problems
As many as 95% of lupus patients experience some type of joint problems. In lupus, joint problems are less likely to cause long-term damage than in other conditions like rheumatoid arthritis.
In lupus, common joint-related complaints include:
- joint pain (arthralgia)
- inflammation causing joints to become stiff, tender, and swollen (arthritis)
- tendon inflammation and looseness, which can cause pain and abnormal bone movements
- a pinching of the nerves in the wrist, known as carpal tunnel syndrome, that typically causing pain, tingling, and numbness in the hand and fingers.
Lupus commonly causes muscle pain, or myalgia. Less commonly, it can cause muscle inflammation — myositis — which typically manifests as muscle weakness that can make it hard for patients to stand up or raise their arms.
People with lupus are at an increased risk of developing osteoporosis, a condition that causes bones to weaken and become more prone to fracture.
Avascular necrosis (AVN), a condition in which there isn’t enough blood supply to a bone and bone tissue starts to die as a result, also can occur in people with lupus. AVN is less common than other problems related to bones and joints. However, it is more common in patients who have been treated with steroids for an extended period of time.
Nervous system problems
In about 40% of people with the disorder, lupus affects the central nervous system, comprised of the brain and spinal cord. This is sometimes called neuropsychiatric lupus, and symptoms may include:
- confusion and difficulty concentrating, sometimes called brain fog
- memory issues
- psychosis, which can include hallucinations (sensing things that aren’t real) and/or delusions (fixed beliefs with no basis in observable reality).
Lupus also can cause peripheral neuropathy, referring to damage to nerves found outside the brain and spinal cord. These nerves help coordinate movement and collect sensory data. Symptoms of peripheral neuropathy can include:
- unexplained pain, tingling, or other unusual sensations
- dizziness and headache
- ringing in the ears or changes in hearing
- drooping face and eyelids.
The autonomic nervous system — the branch of the nervous system responsible for regulating unconscious bodily processes like digestion and heartbeat — also may be affected in lupus. Among the potential symptoms of autonomic dysfunction in lupus are:
- changes in heart rate and blood pressure
- digestive problems like vomiting and diarrhea.
Lupus can affect the eyes and surrounding tissues. This can result in symptoms like:
- impaired vision, driven by damage to blood vessels or nerves in the eyes
- dry eyes
- redness and eye pain caused by inflammation (scleritis).
Heart and lung problems
Around half of lupus patients experience some form of lung involvement over the course of their illness.
Some of these conditions, such as pulmonary hypertension or lung fibrosis, can have serious detrimental effects on lung function. Thus, timely identification and management are key. Symptoms and complications related to lung disease in lupus may include:
- chest pain, especially when breathing deeply
- difficulty breathing or shortness of breath
- high blood pressure in lung blood vessels (pulmonary hypertension)
- scarring (fibrosis) in the lungs
- “shrinking lung syndrome,” which is characterized by a feeling of breathlessness and reduced chest expansion when breathing.
Lupus also may cause inflammation in the heart and surrounding tissues, causing symptoms such as chest pain, irregular heartbeat, and abnormal fluid buildup that can cause swelling. People with lupus are at an increased risk of developing coronary artery disease and other forms of heart disease. Heart disease is the number one cause of death among lupus patients.
Blood and circulatory abnormalities
Blood-related abnormalities that can occur in people with lupus include:
- high blood pressure (hypertension)
- increased risk of blood clotting, which can interfere with blood flow
- a buildup of plaque in the arteries (atherosclerosis)
- low levels of red blood cells that carry oxygen through the body (anemia)
- low levels of white blood cells that fight infection (leukopenia)
- low levels of platelets, which are cell fragments involved in blood clotting (thrombocytopenia)
- blood vessel inflammation (vasculitis), which can cause symptoms like fever and interfere with blood flow, causing additional symptoms as organs are deprived of nutrients and oxygen.
Lupus also can cause changes in circulation, that is, how blood moves through the body. This may manifest with symptoms like:
- redness in the palms of the hands (palmar erythema)
- a lacy or net-like blue or purple pattern visible through the skin (livedo reticularis)
- fingers and toes turning blue and numb in response to cold or stress (Raynaud’s phenomenon).
Lupus may cause inflammation in various digestive organs, giving rise to problems related to digestion. However, digestion-related problems due to lupus itself are not as common as digestion-related side effects of lupus treatments.
Digestive symptoms tied to lupus may include:
- nausea and vomiting
- diarrhea or constipation
- loss of appetite
- pain, swelling, and/or tenderness in the abdomen
Fatigue and fever
Fatigue — persistent feelings of tiredness and low energy, even when well-rested — is one of the most common symptoms of lupus. The inflammation that drives lupus also can result in fever.
Pregnancy complications and reproductive health
Lupus itself usually does not impact fertility, and most people with lupus who choose to conceive are able to do so without unusual difficulty. However, in some cases lupus and related health problems can cause damage to reproductive organs and affect fertility. Some lupus treatments also may cause fertility problems as a side effect, while others may be dangerous to use during pregnancy.
The rate of complications from pregnancy is higher in people with lupus than in the general population. The risk of pregnancy issues like miscarriage is highest in individuals with active disease, or those with underlying health problems like kidney or heart disease.
Despite the higher-than-usual risk, most people with lupus who choose to become pregnant are able to have a healthy pregnancy if appropriate care steps are taken. Lupus patients who wish to become pregnant are advised to talk with their healthcare team at least a few months before they start trying to conceive so that an appropriate care plan can be created.
Many women with lupus experience abnormalities related to menstruation, such as unusually heavy flow (menorrhagia) or irregular periods. Some women with lupus also report that their disease symptoms tend to worsen at certain points in their cycle.
What is a lupus flare?
A flare, also called a flare-up or relapse, is a sudden worsening of lupus symptoms caused by increased activity of the autoimmune attack that drives the disease. Flares are usually followed by periods of remission, where symptoms ease or go away completely.
Flares can vary in severity — some are merely inconvenient, while others can be serious and require medical attention. Some flares last just a few days, while others can go on for months in the absence of treatment. It’s generally advised that people with lupus should contact their healthcare providers immediately if they think they are having a flare.
There is no reliable way to predict when someone with lupus is going to experience a disease flare, though patients can often learn to identify warning signs in their own bodies. Flares may be triggered by infections or other changes in the body that promote inflammation, such as physical stress or injury, as well as by emotional stress.
Lupus News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.